Diagnostic and Therapeutic Challenges of a Large Pleural Inflammatory Myofibroblastic Tumor. (31st December 2012)

• Record Type: Journal Article
• Authors: Loeffler-Ragg, Judith; Bodner, Johannes; Freund, Martin; Steurer, Michael; Uprimny, Christian; Zelger, Bettina; Kähler, Christian M.
• Other Names: Berman M. Academic Editor.; Gonlugur U. Academic Editor.; Hillerdal G. Academic Editor.; Weiler C. Academic Editor.; Wilkens H. Academic Editor.
• Is Part Of: Case reports in pulmonology. Volume 2012(2012)
• Publication Date: 2012-12-31
• Subjects: Lungs -- Diseases -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory infections -- Periodicals; Lung Diseases; Respiratory Tract Diseases; Respiratory Tract Infections; Lungs -- Diseases; Respiratory infections; Respiratory organs -- Diseases; Periodicals; Case Reports; Electronic journals; Periodicals; 616.2
• DOI: 10.1155/2012/102196
• Languages: English
• ISSNs: 2090-6846

Abstract

Abstract : We report a 48-year-old woman with a pleural pseudoneoplasm requiring different diagnostic and therapeutic strategies. After initial presentation with increasing dyspnoea, temperature, dry cough, and interscapular pain diagnostic processing showed a large mediastinal mass with marked pleural effusion and high metabolic activity in the 18F-FDG-PET/CT. Extensive CT-guided biopsy of the tumor reaching from the visceral pleura into the right upper lobe revealed no malignancy, but a marked inflammatory tissue reaction containing foam cells. Initial empiric antibiotic therapy was temporarily successful. However, in the further course the mass relapsed and was resistant to antibiotics and a corticosteroid trial. With the working hypothesis of an inflammatory myofibroblastic tumor the patient underwent surgical tumor resection, finally confirming the suspected diagnosis. Due to residual disease intravenous immunoglobulins were administered leading to sustained response. This case with a pleural localisation of a large inflammatory pseudotumor with responsiveness to immunomodulation after incomplete resection extends the reported spectrum of thoracopulmonary manifestations of this rare entity.